Prevalence and Determinants of Nutritional Status Among Women and Children in Pakistan (original) (raw)

2021, Research Square (Research Square)

Background: Nutrition has been a low-priority area in Pakistan, with low visibility from the political leadership. Despite various efforts, Pakistan has been reported to have one of the highest prevalence of child and women malnutrition compared to other developing counties. Therefore, this study intends to examine the prevalence and determinants of nutritional status of women and children in Pakistan. Methods: The present study uses the Demographic Health Survey (DHS) data from Pakistan 2012-13 (PDHS-3). The nutritional status of women was examined through Body-Mass Index (Underweight, normal, overweight, & obese), and that of children was examined through stunting (severe and moderate), wasting (severe, moderate, overweight), and underweight (severe, moderate, overweight). Descriptive statistics and bivariate analysis have been used along with multinomial logistic regression. Results: A higher proportion of children in rural areas were severely stunted (19.57% vs. 12.49%), severe wasted (2.36% vs. 2.23%), and severe underweight (9.37% vs. 6%) than their urban counterparts. A higher proportion of rural women (9.5% vs. 5.45%) were underweight than urban women, whereas a higher proportion of urban women were obese (24.32% vs. 19.01%) than rural women. The odds of severe stunting (OR= 0.24; C.I.=0.15-0.37), severe underweight (OR= 0.11; C.I.=0.05-0.22) were lower among children from the richest wealth quintile than their poorest counterparts. The Relative Risk Ratio (RRR) of being overweight (RRR= 3.7; C.I.=2.47-5.54) and Obese (RRR= 4.35; C.I.=2.67-7.07) than normal BMI were higher among women from richest wealth quintile than women belonged to poorest wealth quintile. Conclusion: This study has highlighted determinants associated with maternal and child nutritional status, whereby child's nutritional status was measured by stunting, wasting, and underweight, and the mother's nutritional status was measured by BMI. The main risk factors for child's poor nutritional status include low household wealth, urban residence, and mother's educational status. Similarly, the main risk factors for women's poor nutritional status include increasing the women's age, educational status, rural residence, and household wealth. Emphasis should be placed on educating mothers as it would improve their nutritional status and improve their child's nutritional status simultaneously. Background Child undernutrition is a signi cant public health concern for children under the age of ve years in underdeveloped nations including Pakistan. Malnutrition is produced by numerous interconnected causes and has both short and long long-term negative health consequences [1], [2]. According to the 2011 National Nutrition Survey of Pakistan, 31% of children under the age of ve are underweight, whereas a recent research in Pakistan found that the current incidence of underweight children in the nation is 29% [1], [3]. Pakistan is identi ed among those of the seven country that accounted about one-third of population undernourished as Bangladesh, China, Congo, Ethiopia, India, and Indonesia [4]. Undernutrition causes illness and mortality in children, as well as poor physical and cognitive development, poor academic achievement, and a diminished ability to work later in life, resulting in a loss of production and earnings [5]-[7]. As a result, due to its long-term and negative repercussions, undernutrition is one of the most urgent issues of our day [8]. A number of studies reported that inadequate nutrition is the major risk factor for the child malnutrition [9]-[11]. Studies have found that there are multiple factors associated with child undernutrition such as low birth-weight, mother's education, mother's body mass index (BMI), sex of the child, birth order, poor exclusive breast feeding, poor sanitation practices, poverty, dietary diversity, and social inequalities [9], [10], [12]-[16]. Some studies have shown that an individual and community level factors are responsible for the childhood undernutrition [12], [13]. Cumming and Cairncross (2016) concluded that the importance of water, sanitation and hygiene have been recognized as the major risk factors for the health of infant and young children, where the process of stunting is highly concentrated [17]. A study in Uganda stated that children belonging to lower socioeconomic strata are more likely to be undernourished, because of higher vulnerability of food insecurity [18]. One of the most important factor responsible for the child undernutrition is the maternal nutritional status [19]. Undernourished women are more likely to bear underweight children, and undernutrition can have an intergenerational effect [20]. A number of studies have documented that there is a signi cant relationship between mother's poor nutritional status and various pregnancy outcomes such as low birth weight, susceptibility to infections, and growth-challenged and developmentally delayed children [21]. There are several factors that affects the mother's nutrition such as high fertility, poor diet, low socioeconomic status, cultural factors, fertility